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Blow to students as NHIF ends secondary school medical cover

 NHIF Building, Nairobi. [File, Standard]

Despite President William Ruto championing the provision of universal health coverage, a cloud of uncertainty now hangs over the health of millions of secondary school students after the government terminated their comprehensive medical insurance.

The cover dubbed ‘Edu-Afya’ has been in use for the past four and a half years.

The decision, effective December 31, leaves parents and educators to figure out solutions amid the fears of potential impact on students’ well-being.

In a letter seen by The Standard dispatched to healthcare facilities last month, the National Hospital Insurance Fund (NHIF) cautions hospitals it will not compensate them for services provided under the secondary school medical programme beyond the expiry period of the contract on December 31.

“This is to inform you that Edu-Afya Medical Cover for students in public secondary schools which has been in existence since May 2018 will lapse on 31 December 2023,” the letter reads in parts.

“Treatment received or claims launched after the deadline shall not be processed for reimbursement,” it adds. 

The cover was adopted in May of 2018 and is reviewed on an annual basis and renewed through agreement by the Education Ministry and the National Hospital Insurance Fund.

Under the cover, the ministry negotiated an annual premium of Sh1,350 per student.

The scheme offered comprehensive medical insurance coverage for students in public secondary schools registered with the National Educational Management Information System (NEMIS).

The cover would also help in the diagnosis of previously undetected - and therefore untreated - chronic conditions that cause students to miss school regularly.

Nonetheless, the end of the medical cover now raises questions of why a project of such a noble and important cause would be eliminated and the fate of students with existing and undetected chronic conditions.

The last report on the medical scheme made public in 2019 showed 606,893 students sought medical attention between January and December of that year out of the 2.7 million students covered in the same period.

School heads argue that the programme has been underutilised due to complications students face in seeking medication.

“Many health care providers indicated that they require letters from the head teachers in order to attend to students, this delays the access to medical services,” observed Kahi Indimuli Kahi, the outgoing Kenya Secondary Schools Heads Association (KESSHA).

However, in a previous interview, NHIF explained that the number of those seeking medical attention is a true reflection of those who are sick and require medication.

This, the insurer argues, is because the age bracket of those covered is not highly susceptible to serious illnesses.

On Tuesday, the National Parents Association chairman Silas Obuhatsa, cautioned that putting an end to such a programme could hurt the most vulnerable students.

Obuhatsa indicated that the medical scheme has been a pillar for students battling long-term illnesses and could put their education and life on the line if no plans are put to renew it.

“There will be a big problem, remember this is a programme that was aimed at providing preventive, curative and managing chronic diseases, so what will become of the beneficiaries?” Obuhatsa questioned.

It now remains unclear whether the lack of medical cover will affect students’ learning or will contribute to increased absenteeism.

Even though Principals think the idea of providing medical cove is noble, they challenge its financing model.

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